Individual
JOSE RICO SANTONIL SANARIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0443
Mailing address
PO BOX 64382, BALTIMORE, MD 21264-4382
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R164106
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063046200
—
MD
01
—
P01294154
RAILROAD MEDICARE
MD
Enumeration date
12/02/2012
Last updated
10/20/2016
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